DESCRIPTION: (Adapted from applicants abstract) Research on health behavior repeatedly demonstrates the difficulty people have in changing deeply ingrained behavior. While the deleterious effects of smoking are widely recognized, it is still a difficult behavior to change: over 70% of people relapse during any single cessation attempt. Reversal theory directly addresses the difficulty people have with changing old behavior and maintaining new behavior. Previous research under this award demonstrated that reversal theory concepts accurately accounted for the outcomes in over 80% of episodes when ex-smokers were tempted to smoke. Current work under this award has supported the hypothesis that smoking differentially affects CNS arousal depending on reversal theory state. Specific respiratory maneuvers, selected to both increase and decrease CNS arousal, are currently being tested within the context of a community-based cessation program. The overall objective of the proposed work is to expand the results of the current award by addressing the following specific aims: (1) test the use of respiratory maneuvers within a minimal intervention smoking cessation program, designed to be appropriate for delivery by nurses; (2) investigate the mechanisms by which smoking alters measures of CNS activity when reversal theory concepts are taken into account; (3) investigate the effects of transdermal nicotine replacement on CNS performance and subjective state; (4) refine and improve the instruments available for measuring reversal theory concepts in order to apply these concepts to other health-care behaviors; (5) replicate the major previous findings relating reversal theory to smoking and smoking cessation. These aims will be accomplished in a series of three studies. The first aim will be accomplished by a controlled trial of a minimal intervention smoking cessation program that incorporates the use of reversal theory state- appropriate respiratory maneuvers. Approximately 265 people will be recruited over two years to participate in this study. The second aim will be accomplished in a laboratory study in which measures of blood nicotine level, CNS activity and state are obtained each time a subject smokes a cigarette over a 6-hour period. The third aim will be accomplished in a laboratory study in which measures of CNS activity, performance and state will be obtained before and after a cessation attempt which incorporates the use of a transdermal nicotine patch for half of the subjects. Aims 4 and 5 will be incorporated into the three planned studies.